Co-Contributors: Margaret Maxwell, Jayne Noyes, Nicola Ring, Ruth Jepson, Ruth Turley
Based at the University of Sterling
The NHS needs high-quality research information (evidence) to help it design health services and make decisions affecting patients. Pulling together (synthesising) evidence from many existing qualitative studies, such as those using patient interviews, is now seen as important in making sense of research information and is economical. It can explain, for example, how and why health services or policies work or not, why patients or health professionals behave in a certain way, or what it is like to experience an illness. Synthesising evidence from quantitative studies, such as trials, can increase our understanding of what works but qualitative synthesis can explain why things work and explain the range of patient experiences for ANY specific health condition, service or topic.
Meta-ethnography is a respected, thorough qualitative synthesis method in which researchers select and analyse qualitative studies to answer focused questions on a specific topic (e.g. peoples’ experiences of having and being treated for arthritis) to come up with fresh findings and conclusions. Meta-ethnography findings have been used in clinical guidelines. NIHR is a major funder of meta-ethnographies. The reporting quality of published meta-ethnographies varies and is often poor, especially researchers descriptions of what they did to arrive at their findings. Low-quality reporting means that people, such as patients, NHS staff and managers, cannot judge the meta-ethnography s quality and thoroughness. This can lead to lack of trust in meta-ethnography findings (which could be of great benefit) meaning that they are not used to improve decisions, services and patient care. To make sure that evidence from meta-ethnographies is used, researchers must carry out quality meta-ethnographies and report them to a high standard, but there are no guidelines to help researchers do this.
This study aims to create evidence-based meta-ethnography (ME) reporting guidelines articulating the methodological standards and depth of reporting required to improve the quality and transparency of MEs. The guidelines aim is to maximise meta-ethnography s value and utility for enhancing health service design and delivery and understanding patient experiences. Improving patient experiences of care is a key NHS aim.
Our research questions are: 1. What are the existing recommendations and guidance for conducting and reporting each process in a ME, and why? 2. What good practice principles and standards in ME conduct and reporting can we identify from published MEs to inform recommendations and guidance? 3. What is the consensus of experts and other stakeholders on key standards and domains for reporting ME in an abstract and main report/publication?
Our research design to answer these questions follows good practice in research reporting guideline development: Stage 1: systematic scoping review to identify recommendations and guidance in conducting and reporting ME. Output: typology of recommendations/guidance. Stage 2: review and audit of seminal and recent published MEs to define good practice in conduct and reporting. Output: good practice principles; draft guideline standards. Stage 3: workshop and Delphi studies to agree guideline content with 90 QES/ME experts and key stakeholders including patients. Output: guideline statement. Stage 4: develop and widely disseminate a detailed explanatory document to accompany the guideline statement, a NIHR ME report template, and training materials on guideline use. These will internationally raise reporting quality, maximising the likelihood that high-quality MEs can contribute robust evidence to improve patient-centred NHS services for any health condition.